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General NPI Number Information
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NPI Number | 1447246921
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Entity Type | Organization
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Legal Business Name | HUNT SILVER LAKE DRUG INC
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1510 N BROADWAY
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City | ROCHESTER
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State | MN
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Zip | 55906-4146
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Country | US
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Telephone | 507-289-3901
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Fax | 507-529-8353
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Provider Business Mailing Address
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Address Line | 1510 N BROADWAY
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City | ROCHESTER
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State | MN
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Zip | 55906-4146
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHILIP HOMMERDING
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Credential | PHARM D
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Telephone | 507-289-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2609496
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License Number State | MN
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